Conditions and Diseases

Physicians writing on KevinMD about the diseases they treat and the people who have them: cancer and its screening arguments, pain and the drugs that treat it, diabetes and the obesity argument, mental illness and who gets treated for it, and the decisions at the end of a life. Five maintained records draw on this archive: Cancer: what physicians say, in their own words, Opioids: what physicians and pain patients say, in their own words, End of life: what physicians say, in their own words, Diabetes and obesity: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.

The physician burnout fix nobody prescribes

Michael Carlini

June 30, 2026

There’s a quiet assumption baked into how most physicians think about their careers: If you have the capacity to earn a certain income, you should. More RVUs, more shifts, more call. The math always seems to point in one direction.

I want to question that assumption, because I’m watching it cost the doctors I coach something they can’t get back. When physicians come to me feeling depleted, the first instinct, theirs …

Dental fear is not really about pain

Mariam Olayode

Conditions and Diseases

June 30, 2026

I used to hide my smile in photographs.

Not because I was shy. Not because I was having a bad day. But because I had convinced myself that my teeth were too big, too much, too visible. I watched people with smaller, neater teeth and quietly wished mine were different. I kept my lips together in every picture for years.

I am a dental surgery assistant. And for a long time, I …

Read more…

Dental fear is not really about pain

What a code blue feels like when CPR fails

Matthew Russell, MD

Conditions and Diseases

June 30, 2026

An excerpt from House of Perdition.

Ten minutes into the code, and I could already feel the difference. I could feel her broken ribs grind against each other with every compression. The first set of compressions had been stiff, like trying to force a thick textbook to bend in half, the sternum protecting the heart and lungs. Each compression was unforgiving, and the chest recoiled with a force equivalent to …

The closed door: HIV stigma in clinical training

Max Jared Bajer, RN

Conditions and Diseases

June 30, 2026

Her door was always closed. Every other mother on that maternity ward had hers open. You could hear them from the hallway: the soft sounds of newborns, the low voices of partners and grandmothers, the particular exhausted joy of those first hours. Nurses moved in and out freely. Students stopped to peek, to congratulate, to practice the small rituals of care that we were there to learn. The ward had …

Moral injury in medicine: the cost of endless accommodation

Eddie Saliba, APRN, FNP-C

Conditions and Diseases

June 29, 2026

When the pattern became impossible to ignore

A patient came into the office after two or three days of cough, congestion, body aches, and fatigue. Fairly typical upper respiratory symptoms. I offered to test him for COVID. He scoffed and dismissively declined any viral testing.

Apparently he already “knew” what this was. According to him, it was “turning into bronchitis,” and what he “needed” was a Z-pack. I explained that after only …

Why your leaky gut tests aren’t fixing your symptoms

Shiv K. Goel, MD

Conditions and Diseases

June 29, 2026

Irene came in for migraines.

Thirty-six years old. Elementary school teacher. Already diagnosed with irritable bowel syndrome. Already scoped twice, endoscopy and colonoscopy both showing diffuse inflammation, gastritis, GERD. Already told she couldn’t tolerate GLP-1 medications because of her IBS. She had done her research online and found me.

She seemed, on the surface, like a patient with a well-documented GI history and a headache problem. I almost missed what was actually …

The hidden liability inside continuous patient monitoring

Chinmeri Nwuba

Conditions and Diseases

June 29, 2026

Over time, the medical environment has witnessed several happenings that point to an interesting shift in the way patients are monitored. Of late, patients now wear smartwatches that quietly track heart rate variability and oxygen saturation throughout the day. Others rely on a continuous glucose monitor that sends metabolic data to a smartphone in real time. Someone else sleeps with a ring that records temperature, respiratory rate, and patterns …

A poem on the doctor-patient relationship and facing fear

Michele Luckenbaugh

Conditions and Diseases

June 28, 2026

I sit within four silent walls,
Waiting for answers
That may never come.
The clock moves,
The sun rises and falls,
Yet the questions remain.
Uninvited companions occupying
Every corner of the room.

What is happening within me?
Why does this pain cling so tightly,
Wrapping itself around muscle, bone,
Thought and spirit?

I try to escape it.
I call upon memories of laughter,
Of loved ones gathered around a table,
Of morning birdsong
And summer breezes moving through trees.

But pain is stubborn.
It follows me there,
Casting …

How to build an ADHD treatment plan beyond medication

Carrie Friedman, NP

Conditions and Diseases

June 28, 2026

When a child is diagnosed with ADHD, the conversation is often much narrower. Medication. Maybe a school form. Maybe a vague suggestion to “try therapy.” Then parents are sent back into the same exhausted home, the same chaotic mornings, the same homework battles, the same social struggles, the same emotional explosions, and the same school system that often does not know what to do with a child who is bright, …

Racial bias in schizophrenia diagnosis must end

Timothy Lesaca, MD

Conditions and Diseases

June 28, 2026

A young Black woman waits in a psychiatric emergency room. She is grieving, traumatized, and depressed. The clinician, however, describes her as “guarded,” “hostile,” and “paranoid” in the chart. She leaves with a schizophrenia diagnosis, a prescription for a first-generation antipsychotic, and a future shaped by a label she should never have received.

This is not a hypothetical situation. The Harvard Review of Psychiatry documented this case in 2023. She was …

Post-acute ventilator care does not end at discharge

JoNel Chensky, RRT

Conditions and Diseases

June 28, 2026

A patient discharged from the ICU on a ventilator may no longer fit the traditional image of “critical care,” but that does not mean the medical complexity disappears.

In post-acute ventilator units, respiratory failure continues to be managed every day through ventilator monitoring, airway and secretion management, weaning attempts, oxygen titration, tracheostomy care, and ongoing assessment across interdisciplinary teams. The setting changes. The clinical dependency often does not. Yet once these …

Rushed adult ADHD evaluations put patients at risk

Carrie Friedman, NP

Conditions and Diseases

June 26, 2026

Adult ADHD is real. It is impairing. It is often missed, especially in bright, high-achieving adults, women, and people who learned to compensate for years before finally burning out. But the solution to underdiagnosis cannot be overdiagnosis.

We are now seeing a second problem emerge: rushed adult ADHD evaluations, often completed in 30 to 60 minutes, sometimes based heavily on a brief questionnaire, followed quickly by stimulant prescribing. The patient …

Central sensitization is the key to treating chronic pain

Eric Anderson, MD, PhD, MBA

Conditions and Diseases

June 26, 2026

Behavioral health is a core component of first-line, non-opioid treatment for chronic pain in most major medical guidelines, including the Centers for Disease Control and Prevention, the American College of Physicians, the World Health Organization, the American Academy of Neurology, the American Headache Society, and the American College of Gastroenterology. And yet, the concept of behavioral health to treat chronic pain still surprises many people, including …

Why the case against APOE4 testing no longer holds

Ron Carr

Conditions and Diseases

June 26, 2026

I remember the moment clearly. A hot July day, standing at my mailbox, opening an envelope from a genetic testing company. I expected reassurance. Instead, I saw a result sitting in the bright red end of the risk continuum. As far from “OK” as it could get.

Years earlier, my son had mentioned that his 23andMe test showed he carried a gene that might lead to Alzheimer’s “when he was old.” …

Early Alzheimer’s diagnosis now decides who gets treated

Dr. Emer MacSweeney

Conditions and Diseases

June 26, 2026

When Bill Ritter, a longtime anchor for WABC-TV New York’s ABC7 Eyewitness News, recently announced that he had been diagnosed with early-stage Alzheimer’s disease, he shared that he is receiving treatments that are keeping the disease’s progression at bay. Unfortunately, many patients never receive the same opportunity for treatment because they are diagnosed too late.

With Alzheimer’s disease, delayed diagnosis can determine whether patients qualify for new treatments, clinical trials, and …

Rethinking neuroplasticity and mental health in psychiatry

Farid Sabet-Sharghi, MD

Conditions and Diseases

June 26, 2026

Every week, a familiar reflection settles into the corners of my mind as I look at my office desk. As a practicing psychiatrist, my days are spent navigating a gentle but persistent paradox. On one hand, my workspace is increasingly filled with paperwork: diagnostic standardizations, complex neuropsychological testing matrices, and formal institutional accommodation forms designed to categorize human behavior into neat, permanent columns. On the other hand, sitting across from …

The thermodynamics of depression brain fog

Ronke Lawal, MBA

Conditions and Diseases

June 26, 2026

The first law: Nothing is lost

“I used to be smart, now I can’t think. I used to solve puzzles pretty easily, but now I don’t have any logic whatsoever. Sometimes I don’t even remember the days I had a week ago. I don’t know why my brain doesn’t work anymore.”

I kept seeing the same grief in different words: people who were not simply sad, but bewildered by the disappearance of …

Why women miss mammograms has nothing to do with awareness

Ryan Polselli, MD

Conditions and Diseases

June 25, 2026

For years, we have told women to get their mammograms. We have wrapped buildings in pink lights. We have filled October with ribbons, walks, campaigns, commercials, survivor stories, and reminders. We have created an entire cultural season around breast cancer awareness. And still, millions of women do not get screened on time.

At some point, we have to ask a more uncomfortable question: What if awareness was never the real problem?

As …

How to rethink old breast implants as your body ages

Tyler Frew, MD

Conditions and Diseases

June 25, 2026

Not long ago, a woman came into my office with breast implants that were forty-one years old. The implants were older than I am.

As a plastic surgeon who specializes in breast and body procedures, that is the longest I have personally seen implants last. And honestly, my first reaction was probably the same reaction most people would have: disbelief. Forty-one years is an incredibly long time for any medical device …

When hearing loss in older adults steals connection

Rupa Rao

Conditions and Diseases

June 25, 2026

Life’s most meaningful memories are often built around shared experiences. Whether it’s a wedding toast, a graduation ceremony, a holiday dinner, or a grandchild’s soccer game, these are the moments families remember for years, not because of where they happened, but because of the conversations, laughter, and connections that took place along the way. Unfortunately, hearing loss can create invisible barriers that prevent people from fully experiencing those moments.

As …

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